PHRN - Medical Billing | Shifting Schedule | Onsite | Pasig City

TASQ Staffing Solutions; Pasig; Vor Ort; Vollzeit

Benefits dieser Stelle

Signing bonus

Zusammenfassung

A staffing solutions company is seeking a Coverage and Access Specialist (PHRN) for 100% onsite work in Ortigas, Pasig City. The ideal candidate will have an active PHRN license and good English communication skills. Responsibilities include interacting with insurance payers for benefit verifications, and managing cases throughout the patient journey. BPO experience is not required but is a plus. Night shifts are predominant in this role.

Qualifikationen

• Must have an active PHRN license.
• Good English communication skills are essential.
• Knowledge of healthcare regulations is necessary.

Aufgaben

• Interact with insurance payer representatives for benefit verifications.
• Document payer interactions to inform cross-functional partners.
• Manage assigned cases throughout the patient journey.

Kenntnisse

Good English communication skills

Ability to work independently

Knowledge of healthcare regulations and compliance

Ausbildung

Active PHRN license

Jobbeschreibung

WITH SIGNING BONUS!

Work setup: 100% Onsite (Ortigas, Pasig City)
Shift: Shifting schedule - predominantly Nightshift

Responsibilities

Coverage and Access Specialist (PHRN)

• Professionally and compliantly interact with insurance payer representatives during outbound phone calls for benefit verifications (New BVs, Annual reverification BVs and Bridge Eligibility Checks) and coverage exception follow up calls (Prior Authorization (Pas), Non- Formulary Exceptions (NFEs) and Appeals)
• Volume and case type to be worked to be determined by Novartis, but in collaboration with supplier based on current SLAs within the PSC and expected agent productivity
• Accurately and concisely document payer interactions to inform cross-functional partners on the patients coverage status

Care Navigator (PHRN)

• Develop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned program
• Learn and utilize protocols to respond to customer phone, chat, fax, SMS / text, mail, and e-mail inquiries as well as other communication channels in a prompt and courteous manner
• Professionally and compliantly interact with customers, relevant Novartis associates, and other external contacts during inbound and outbound phone calls
• Manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required

Requirements

• Must have an active PHRN license
• With or without BPO experience
• Good English communication skills
• Knowledge of healthcare regulations and compliance
• Ability to work independently and as part of a team